Kuyini Ukudla Okunomsoco Okuphelele? Inhloso, Inqubo & Ukuphatha

Ukudla okunomsoco okuphelele (TPN) kuyindlela ekhethekile yokuletha ukudla okuphelele ngqo emgudwini wakho wegazi ngomthambo. Le ndlela yokudla yezokwelapha idlula ngokuphelele uhlelo lwakho lokugaya ukudla, inikeza wonke amakhalori, amaprotheni, amafutha, amavithamini, namaminerali umzimba wakho owudingayo ukuze ululame futhi usebenze kahle uma ungenakudla noma ukumunca ukudla ngokujwayelekile.

Kuyini Ukudla Okunomsoco Okuphelele?

Ukudla okunomsoco okuphelele kuyifomula yokudla oketshezi equkethe konke umzimba wakho okudingayo ukuze uphile futhi uchume. Igama elithi "parenteral" limane nje lisho "ngaphandle kwamathumbu," ngakho-ke lokhu kudla kungena ngqo emgudwini wakho wegazi kunokuba kudlule esiswini sakho namathumbu.

Cabanga nge-TPN njengokudla okuphelele ngesimo soketshezi olwenzelwe izidingo zomzimba wakho eziqondile. Ithimba lochwepheshe bezempilo, okuhlanganisa odokotela, osokhemisi, kanye nabahlengi bokudla, basebenzisana ukudala ifomula eyenziwe ngokwezifiso ehambisana nezidingo zakho ezithile zokudla okunomsoco, isimo sezokwelapha, nesisindo somzimba.

Isixazululo ngokuvamile siqukethe ibhalansi eqaphelayo yamaprotheni (ama-amino acid), ama-carbohydrate (ngokuvamile i-glucose), amafutha (ama-lipids), ama-electrolyte afana ne-sodium ne-potassium, amavithamini, kanye namaminerali alandelwayo. Le ndlela ebanzi iqinisekisa ukuthi umzimba wakho uthola konke okudingayo ukuze ugcine ubukhulu bemisipha, usekele ukusebenza kwezitho, futhi ukhuthaze ukuphulukiswa.

Kungani Kwenziwa Ukudla Okunomsoco Okuphelele?

Udokotela wakho angase ancome i-TPN uma uhlelo lwakho lokugaya ukudla ludinga ukuphumula okuphelele noma lungakwazi ukumunca kahle izakhamzimba. Lesi simo singavela ngezizathu ezihlukahlukene zezokwelapha, futhi i-TPN isebenza njengebhuloho lesikhashana lokugcina umzimba wakho unomsoco ngenkathi ululama.

Izizathu ezivame kakhulu ze-TPN zihlanganisa izimo ezinzima zokuvuvukala kwamathumbu njengesifo sikaCrohn noma i-ulcerative colitis ngesikhathi sokusha, ukuhlinzwa okukhulu kwesisu okudinga ukuthi amathumbu akho aphumule, ukwelashwa okuthile komdlavuza okuthinta ikhono lakho lokudla noma lokugaya ukudla, kanye ne-pancreatitis enzima lapho ukudla kungase kubhebhethekise isimo.

Abanye abantu badinga i-TPN ezimweni zesikhashana, njengokululama ekuhlinzweni okuyinkimbinkimbi noma ukuphatha izinkinga ezivela ekwelashweni kwezokwelapha. Abanye bangase bayidinge isikhathi eside uma benezimo ezingapheli ezivimbela ukudla nokugaya okuvamile.

Izinsana ezingakazalwa zivame ukuthola i-TPN ngoba izinhlelo zabo zokugaya azikathuthuki ngokugcwele. Ngaphezu kwalokho, abantu abanokusha okukhulu, izimo ezithile zofuzo ezithinta ukumuncwa kwezakhi, noma labo abahlangabezana nesicanucanu eside nokuhlanza bangazuza kulokhu kusekelwa kokudla okunomsoco.

Yini Inqubo Yokudla Okunomsoco Okuphelele Kwe-Parenteral?

Inqubo ye-TPN iqala nethimba lakho lezempilo linquma izidingo zakho ezithile zokudla okunomsoco ngokusebenzisa ukuhlolwa kwegazi nokuhlolwa kwezokwelapha okucophelelayo. Bazobala ngqo ukuthi mangaki amakhalori, amaprotheni, nezinye izakhi zomzimba wakho ozidingayo ngokusekelwe esisindweni sakho, isimo sezempilo, kanye nezinga lomsebenzi.

Okulandelayo, uzodinga uhlobo olukhethekile lomugqa we-IV obizwa nge-central venous catheter. Le tube encane, eguquguqukayo ivamise ukufakwa emthanjeni omkhulu esifubeni sakho, entanyeni, noma engalweni. Le nqubo yenziwa ngaphansi kwezimo eziyinyumba, ngokuvamile endaweni yasesibhedlela, futhi uzothola i-anesthesia yendawo ukunciphisa ukungakhululeki.

Uma i-catheter isikhona, isixazululo se-TPN silethwa ngepompo ye-IV elawula izinga lokugeleza ngokunembile. Le pompo iqinisekisa ukuthi uthola inani elifanele lokudla okunomsoco ngesikhathi esithile, ngokuvamile ngaphezu kwamahora angu-12 kuya kwangu-24 kuye ngezidingo zakho.

Iqembu lakho lezempilo lizokugada ngokucophelela kuyo yonke le nqubo. Bazohlola amazinga kashukela egazini lakho, ukulinganisela kwama-electrolyte, nezinye izinto ezibalulekile njalo. Ifomula ye-TPN ingalungiswa nsuku zonke ngokuya ngokuthi umzimba wakho usabela kanjani nezidingo zakho zokudla eziyashintshayo.

Ungalungiselela Kanjani Ukudla Kwakho Okuphelele Kwe-Parenteral?

Ukulungiselela i-TPN kuhilela izinyathelo eziningana ezibalulekile ezisiza ukuqinisekisa ukuphepha kwakho nokusebenza kahle kokwelashwa. Ithimba lakho lezempilo lizokuqondisa esigabeni ngasinye sokulungiselela ukwenza inqubo ibe lula ngangokunokwenzeka.

Okokuqala, uzokwenza umsebenzi wegazi ophelele ukuze umise isimo sakho sokudla okunempilo. Lezi zivivinyo zilinganisa amazinga akho amaprotheni, ukulinganisela kwama-electrolyte, ushukela wegazi, ukusebenza kwesibindi, nezinye izinto ezibalulekile ezisiza ithimba lakho ukuthi liklame ifomula ye-TPN efanele wena.

Ithimba lakho lezokwelapha lizobuye libuyekeze yonke imithi yakho yamanje nezithasiselo. Eminye imithi ingase idinge ukulungiswa ngoba i-TPN ingathinta indlela umzimba wakho oqhubula ngayo imithi ethile. Qiniseka ukuthi utshela abahlinzeki bakho bezempilo ngamavithamini, amakhambi, noma imithi ethengwa ngaphandle kwemvume kadokotela oyithathayo.

Uma ufaka umugqa ophakathi njengenqubo ehlukile, ungase udinge ukuzila ukudla amahora ambalwa ngaphambi kwalokho. Umhlengikazi wakho uzohlinzeka ngemiyalelo ethile mayelana nokudla, ukuphuza, nanoma yimiphi imithi okufanele uyithathe noma uyigweme ngaphambi kokufakwa kwe-catheter.

Kuyasiza ukuhlela ukuthi othile akuqhubele ekhaya uma wenza le nqubo njengesiguli esingaphandle. Ukuba nomuntu ozokusekela naye kungahlinzeka ngenduduzo engokomzwelo ngalesi sikhathi.

Ungawafunda Kanjani Imiphumela Yakho Yokudla Okuphelele Kwe-Parenteral?

Ukuqonda imiphumela yakho yokuqapha i-TPN kukusiza ukuthi uhlale unolwazi mayelana nentuthuko yakho yokudla okunempilo. Ithimba lakho lezempilo lizolandela izilinganiso eziningana ezibalulekile ukuze liqinisekise ukuthi ukwelashwa kusebenza ngempumelelo nangokuphepha.

Amazinga kashukela egazini ahlolwa njalo, ikakhulukazi uma uqala i-TPN. Amazinga avamile ngokuvamile aphakathi kuka-80-180 mg/dL, nakuba okuhlosiwe kungase kuhluke kancane ngokuya ngesimo sakho sezempilo. Ukufundwa okuphezulu kungase kusho ukuthi ifomula yakho ye-TPN idinga ukulungiswa.

Izimpawu zamaprotheni njenge-albumin ne-prealbumin zikhombisa ukuthi umzimba wakho usebenzisa kahle kangakanani ukudla. Amazinga e-Albumin aphakathi kuka-3.5-5.0 g/dL ngokuvamile athathwa njengavamile, kuyilapho amazinga e-prealbumin angu-15-40 mg/dL ekhombisa isimo esihle sokudla okunomsoco.

Ukulinganisela kwe-electrolyte kubalulekile ekusebenzeni kahle komzimba wakho. Ithimba lakho liqapha i-sodium (135-145 mEq/L), i-potassium (3.5-5.0 mEq/L), namanye amaminerali ukuvimbela ukungalingani okungase kubangele izinkinga.

Ushintsho lwesilinganiso somzimba nalo luyizinkomba ezibalulekile. Ukuzuza isisindo kancane kancane noma isisindo esizinzile ngokuvamile kusikisela ukuthi i-TPN inikeza ukudla okunomsoco okwanele, kuyilapho izinguquko ezisheshayo zesilinganiso somzimba zingase zibonise ukugcinwa kwamanzi noma ama-calories anganele.

Ungayiphatha kanjani i-Total Parenteral Nutrition yakho?

Ukuphatha i-TPN ngempumelelo kuhilela ukusebenza eduze nethimba lakho lezempilo nokulandela imihlahlandlela ethile ukuqinisekisa ukuphepha kwakho nempumelelo yokwelashwa. Ukubamba iqhaza kwakho ngentshiseko kulolu hlelo kwenza umehluko omkhulu emiphumeleni yakho.

Ukugcina indawo ye-catheter ihlanzekile futhi yomile ngumsebenzi wakho obaluleke kakhulu. Umnakekeli wakho uzokufundisa amasu okuzinakekela afanele, okuhlanganisa indlela yokushintsha izingubo nokubona izimpawu zokutheleleka njengobubomvu, ukuvuvukala, noma ukukhishwa okungavamile endaweni yokufaka.

Ukulandela isimiso sokufakwa esinqunyiwe kubalulekile ekugcineni amazinga okudla okunomsoco azinzile. Uma uthola i-TPN ekhaya, uzofunda ukusebenzisa ipompo lokufaka kahle futhi uqonde ukuthi ungaluqala nini futhi ulumise nini ukwelashwa nsuku zonke.

Ukwenziwa kwezivivinyo zegazi njalo kunika ithimba lakho ithuba lokulandela intuthuko yakho nokulungisa ifomula ye-TPN njengoba kudingeka. Ungazishayi indiva lezi zikhathi zokuhlolwa, ngoba zibalulekile ekuvikeleni izinkinga nasekuqinisekiseni ukuthi uthola ukudla okunempilo okufanele.

Xhumana njalo nethimba lakho lezempilo mayelana nanoma yiziphi izimpawu noma izinkathazo. Bika umkhuhlane, amaqhwa, ukukhathala okungavamile, noma izinguquko endleleni ozizwa ngayo, ngoba lokhu kungase kubonise izinkinga ezidinga ukunakekelwa ngokushesha.

Yini Indlela Engcono Kakhulu Yokudla Okunempilo Okuphelele Nge-Parenteral?

Indlela engcono kakhulu ye-TPN yileyo eyenzelwe ngqo izidingo zakho zomuntu ngamunye nesimo sezokwelapha. Akukho ikhambi elilodwa elingalingana wonke umuntu ngoba izidingo zokudla okunempilo zawo wonke umuntu nezimo zezokwelapha zihlukile.

Ithimba lakho lezempilo lizocabangela izici eziningana lapho liklama uhlelo lwakho olungcono kakhulu lwe-TPN. Lokhu kufaka phakathi iminyaka yakho, isisindo, isimo sezokwelapha, izinga lomsebenzi, nokuthi kulindeleke isikhathi esingakanani ukuthi uzodinga ukusekelwa kokudla okunempilo.

Umgomo uwukuhlinzeka ngokudla okunempilo okuphelele ngenkathi kuncishiswa izinkinga. Lokhu ngokuvamile kusho ukuqala ngefomula eqondayo bese uyilungisa kancane kancane ngokuya ngendlela umzimba wakho osabela ngayo. Ithimba lakho lizolinganisela ukuhlinzeka ngamakhalori kanye nezakhamzimba ezanele ngenkathi ligwema ukondla ngokweqile, okungadala izinkinga zalo.

Abanye abantu benza kahle ngokufakwa kwe-TPN okuqhubekayo emahoreni angama-24, kanti abanye bayazuza ekuyihambiseni emahoreni ayi-12-16 ukuze bavumele imisebenzi yansuku zonke ejwayelekile. Indlela yakho yokuphila nezidingo zezokwelapha zizokusiza ukuthi unqume uhlelo olungcono kakhulu kuwe.

Ziyini Izici Zengozi Yezinkinga Ze-TPN?

Ukuqonda izici eziyingozi zezinkinga ze-TPN kukusiza wena nethimba lakho lezempilo ukuthi nithathe izinyathelo zokuphepha ezifanele. Ngenkathi i-TPN ngokuvamile iphephile uma iphathwa kahle, izici ezithile zingakhuphula ingozi yakho yezinkinga.

Ukuba nesistimu yomzimba yokuzivikela esengozini kukubeka engozini enkulu yokutheleleka okuhlobene nomugqa ophakathi. Lokhu kuhlanganisa abantu abanesifo sikashukela, umdlavuza, noma labo abathatha imithi ecindezela amasosha omzimba. Ithimba lakho lizothatha izinyathelo ezengeziwe zokugcina izimo zihlanzekile.

Isifo sesibindi noma sezinso singathinta indlela umzimba wakho osebenzisa ngayo izakhamzimba ku-TPN. Abantu abanezimo ezinjalo badinga ukuqashwa kaningi futhi bangase badinge amafomula akhethekile aguquliwe ukuvimbela izinkinga.

Okuhlangenwe nakho kwangaphambilini ngemigqa ephakathi noma ama-catheter e-IV kungakhuphula ingozi yakho yezinkinga uma uke waba nokutheleleka noma ezinye izinkinga esikhathini esidlule. Ithimba lakho lokunakekelwa kwezempilo lizocabangela le mlando lapho lihlela ukunakekelwa kwakho.

Ukuba mncane kakhulu noma ukuguga nakho kungakhuphula izingozi zezinkinga. Izinsana ezingakazalwa nabantu abadala ngokuvamile badinga ukuqashwa okucophelelayo futhi bangase badinge amafomula alungisiwe ukuze kubalwe izidingo zabo ezihlukile zokudla okunomsoco.

Ingabe Kungcono Ukuba ne-TPN yesikhashana noma yesikhathi eside?

Ubude be-TPN buqondene ngokuphelele nesimo sakho sezokwelapha nokuqhubeka kokululama, hhayi kulokho okungase kubonakale kukuhle. Ithimba lakho lokunakekelwa kwezempilo lizotusa ubude obufushane obusebenzayo ukuze buhlangabezane nezidingo zakho zokudla okunomsoco ngenkathi umzimba wakho uphola.

I-TPN yesikhashana, evame ukuhlala izinsuku eziyisambulela emasontweni ambalwa, ivame ukusetshenziswa ngemva kokuhlinzwa noma ngesikhathi sokugula okukhulu. Le ndlela inciphisa ingozi yezinkinga ngenkathi inikeza ukudla okunomsoco okubalulekile ngezikhathi ezibucayi zokululama.

I-TPN yesikhathi eside, ehlala izinyanga noma iminyaka, ngezinye izikhathi iyadingeka ezimweni ezingapheli ezivimbela ukudla nokugaya okuvamile. Ngenkathi lokhu kudinga ukuqashwa okucophelelayo, kungase kube yimpilo kubantu abanezimo ezithile zezokwelapha.

Okubalulekile ukubuyela ekudleni okuvamile ngokushesha nje lapho kuphephile futhi kufanelekile ngokwezokwelapha. Ithimba lakho lokunakekelwa kwezempilo lizohlola njalo ukuthi ungaqala yini ukudla ukudla futhi, noma ngabe kungamanani amancane ekuqaleni.

Ziyini Izinkinga Ezingase Zibe Khona Zokudla Okugcwele Nge-Parenteral?

Ngenkathi i-TPN ngokuvamile iphephile uma iphathwa ngendlela efanele, kubalulekile ukuqonda izinkinga ezingase zibe khona ukuze ukwazi ukuqaphela izimpawu zokuxwayisa futhi ufune usizo ngokushesha. Izinkinga eziningi zingavinjelwa ngokunakekela nokugadwa okufanele.

Ukutheleleka kungenye yezinkinga ezinzima kakhulu ngoba umugqa ophakathi nendawo unikeza indlela eqondile eya egazini lakho. Izimpawu zihlanganisa umkhuhlane, amaqhafuza, ububomvu noma ukuvuvukala endaweni ye-catheter, nokuzizwa ungaphilile ngokujwayelekile. Lezi zimpawu zidinga ukunakekelwa kwezokwelapha ngokushesha.

Izinkinga zikashukela egazini zingenzeka ngoba i-TPN iqukethe i-glucose. Abanye abantu bathuthukisa amazinga kashukela egazini aphezulu, ikakhulukazi lapho beqala ukwelashwa. Ithimba lakho lizokugada lokhu ngokucophelela futhi lingase lilungise ifomula yakho noma lincomise imithi uma kudingeka.

Izinkinga zesibindi zingathuthuka ngokusebenzisa i-TPN yesikhathi eside. Ithimba lakho lezempilo lizogada izivivinyo zomsebenzi wesibindi njalo futhi lingase lilungise ifomula yakho ye-TPN uma kwenzeka izinkinga. Izinguquko eziningi zesibindi ziyaguquleka uma zitholwe ngokushesha.

Ukungalingani kwe-electrolyte kungabangela izimpawu ezihlukahlukene kuye ngokuthi yimaphi amaminerali athintekayo. Lokhu kungase kuhlanganise ubuthakathaka bemisipha, ukushaya kwenhliziyo okungajwayelekile, noma ukudideka. Ukuhlolwa kwegazi okuvamile kusiza ekuvikeleni lezi zinkinga.

Izinkinga zemishini ezihlobene nomugqa ophakathi nendawo azivamile kodwa zingahlanganisa i-catheter ivaleke noma isuswe endaweni. Ithimba lakho lezempilo lizokufundisa izimpawu zokuxwayisa okufanele uziqaphele nokuthi ungaziphendula kanjani.

Kufanele Ngibone Nini Udokotela Ngezinkinga Ezihlobene ne-TPN?

Ukwazi ukuthi ungathintana nini nethimba lakho lezempilo kubalulekile ekuphepheni kwakho ngenkathi uthola i-TPN. Ezinye izimo zidinga ukunakekelwa kwezokwelapha ngokushesha, kanti ezinye zingalinda ukuqokwa kwakho okulandelayo okuhleliwe.

Xhumana nodokotela wakho ngokushesha uma uba nomkhuhlane, amaqhafuza, noma uzizwa ungaphilile ngokujwayelekile. Lezi zimpawu zingase zikhombe ukutheleleka, okudinga ukwelashwa ngokushesha. Ungalindi ukubona ukuthi izimpawu ziyathuthuka yini zodwa.

Noma yiziphi izinguquko endaweni yakho ye-catheter zidinga ukunakwa. Lokhu kufaka phakathi ububomvu, ukuvuvukala, ubuhlungu, ukukhipha okungavamile, noma uma i-catheter ibonakala ivulekile noma isusiwe. Lezi zinguquko zingase zikhombe ukutheleleka noma izinkinga zemishini.

Ukuphefumula kanzima, ubuhlungu besifuba, noma ukuvuvukala ezingalweni zakho noma entanyeni kufanele kuholele ekuhlolweni kwezokwelapha ngokushesha. Lezi zimpawu zingase zikhombe izinkinga ezingathi sína ezihlobene nomugqa ophakathi nendawo.

Xhumana nethimba lakho lezempilo uma uhlangabezana nesicanucanu esiqhubekayo, ukuhlanza, ukukhathala okungavamile, noma izinguquko ekucaceni kwakho kwengqondo. Lezi zimpawu zingase zikhombe izinkinga ze-metabolic ezidinga ukuhlolwa.

Izinkinga ngemishini yakho ye-TPN, njengama-alamu e-pompo angeke acace noma ukukhathazeka ngokubukeka kwesisombululo, kufanele kubikwe ngokushesha. Ithimba lakho lezempilo linganikeza isiqondiso futhi liqinisekise ukuphepha kwakho.

Imibuzo Evame Ukubuzwa Mayelana Nokudla Okunomsoco Okuphelele

Q1. Ingabe i-Total Parenteral Nutrition ilungele ukuzuza isisindo?

I-TPN ingasekela ukuzuza isisindo esinempilo uma isetshenziswa ngendlela efanele ngaphansi kokuqondisa kwezokwelapha. Umgomo oyinhloko we-TPN ukuhlinzeka ngokudla okuphelele uma ungenakudla ngokujwayelekile, futhi ukuzuza isisindo kungenzeka ngenxa yemvelo yokuhlangabezana nezidingo zomzimba wakho zokudla okunomsoco. Kodwa-ke, i-TPN ayivamisile ukusetshenziselwa ukuzuza isisindo kuphela kubantu abanempilo ngoba ithwala izingozi ezingaphezu kwezinzuzo uma ukudla okuvamile kungenzeka.

Q2. Ingabe i-TPN yesikhathi eside ibangela izinkinga zesibindi?

I-TPN yesikhathi eside ingase ithinte ukusebenza kwesibindi, ikakhulukazi ezinsaneni ezingakazalwa kanye nabantu abayithola isikhathi eside. Kodwa-ke, amafomula e-TPN anamuhla kanye nokuqapha okucophelelayo kunciphise kakhulu le ngozi. Ithimba lakho lezempilo lizohlola njalo izivivinyo zokusebenza kwesibindi futhi lingashintsha ifomula yakho uma kwenzeka noma yiziphi izinkinga. Izinguquko eziningi zesibindi ezihlobene ne-TPN ziyabuyiseka uma zitholwe ngokushesha futhi ziphathwe ngendlela efanele.

Q3. Ngingakwazi yini ukudla ngenkathi ngithola i-TPN?

Ukuthi ungadla yini ngenkathi uthola i-TPN kuncike esimweni sakho sezokwelapha kanye nezincomo zikadokotela. Abanye abantu bathola i-TPN ngenkathi beqala kancane kancane ukwethula amanani amancane okudla, kanti abanye badinga ukuphumula kwamathumbu okuphelele. Ithimba lakho lezempilo lizokuqondisa mayelana nokuthi ungalidla nini nokuthi yini ongayidla ngokusekelwe esimweni sakho esithile kanye nentuthuko yokululama.

Q4. Umuntu angayithola isikhathi esingakanani i-TPN ngokuphepha?

Ubude be-TPN buhluka kakhulu kuye ngezidingo zomuntu ngamunye zezokwelapha. Abanye abantu bayayithola izinsuku ezimbalwa nje ngemva kokuhlinzwa, kanti abanye abanezimo ezingapheli bangase bayidinge izinyanga noma iminyaka. Ithimba lakho lezempilo lizohlola njalo ukuthi usayidinga yini i-TPN futhi lizosebenza ekukuyiseni ekudleni okuvamile ngokushesha nje lapho kufaneleka ngokwezokwelapha futhi kuphephile.

Q5. Zikhona ezinye izindlela ze-Total Parenteral Nutrition?

Yebo, zikhona ezinye izindlela ezingasetshenziswa kuye ngesimo sakho. Ukudla nge-enteral (ukondla nge-tube) ngohlelo lwakho lokugaya ukudla kuvame ukukhethwa lapho amathumbu akho engasebenza kodwa ungenakudla ngendlela evamile. Ukudla okuyingxenye ye-parenteral kunikeza ezinye izakhamzimba nge-IV ngenkathi udla amanani amancane okudla. Ithimba lakho lezempilo lizokhetha inketho engcono kakhulu ngokusekelwe esimweni sakho esithile sezokwelapha kanye nekhono lohlelo lwakho lokugaya ukudla lokusebenza.